| NPI | 1932384377 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX P3592) |
| Additional Taxonomies | 174400000X Specialist (Licence: TX P3592) |
| Enumeration Date | 2008-01-03 |
| Last Update Date | 2025-07-24 |